Infographic: Signs of a Heart Attack in Men & Women

Tuesday, 17 July, 2018

The signs of a heart attack can vary greatly between men and women. So much so that they can be mistaken for less serious health issues - like a tummy ache. We created this infographic to help you know what to look for.

Signs of a Heart Attack in Men May Include:

  • Lightheadedness: You may feel dizzy or feel like you might pass out.
  • Anxiety: You may feel a sense of doom or feel like you're having a panic attack for no reason.
  • Shortness of Breath: You may pant for breath or try to take deep breaths. This often occurs BEFORE you develop chest discomfort.
  • Chest Discomfort or Pain - Upper Body Pain: This can feel like a tight ache, pressure, fullness or squeezing in the center of your chest lasting more than a few minutes. Pain or discomfort may spread beyond your chest to your shoulders, arms, back, neck, teeth or jaw.
  • Stomach Pain: Pain may extend downward into your abdominal area and may feel like heartburn.
  • Nausea and Vomiting: You may feel sick to your stomach or vomit.
  • Sweating: You may suddenly break into a sweat with cold, clammy skin.

Signs of a Heart Attack in Women May Include:

  • Lightheadedness: You may feel dizzy or feel like you might pass out.
  • Shortness of Breath: You may pant for breath or try to take deep breaths.This may occur with or without chest discomfort.
  • Chest Discomfort: Discomfort or presssure in the center of the chest. It often lasts more than a few minutes, or goes away and returns.
  • Upper Body Pain: Pain in one or both arms, upper back, neck, jaw or stomach.
  • Stomach Pain: Pain may extend downward into your abdominal area and may feel like heartburn.
  • Nausea and Vomiting: You may feel sick to your stomach or vomit.
  • Sweating: Paleness or you may suddenly break into a sweat with cold, clammy skin.
  • Inability to Sleep: You may experience insomnia. 
  • Unusual Fatigue: You may feel more tired than usual or for no apparent reason.

Schedule an Appointment Today

We offer a wide range of services listed here. Call us at 919-852-3999 or email us at with any questions or to schedule an appointment. We look forward to working with you!

Not-So-Summer-Fun: Summer Healthcare & Travel Vaccinations

Tuesday, 17 July, 2018

Summer is a time for playing outdoors, for traveling, for swimming and biking, for baseball games -- and for visits to the doctor. All this great weather and outdoor fun means an increased risk of illness and injury, from minor mishaps (like bee stings and sunburns) to real causes for concern (like sports injuries and accidents).

But summer healthcare concerns don’t have to ruin your fun! Come to Generations Family Practice for convenient medical care and thoughtful treatments from Cary’s favorite family doctors.

Our primary care capabilities includes comprehensive summer healthcare services, including:

At Generations Family Practice, our goal is to help you stay healthy and happy so you can enjoy all the best of summer -- whether you’re traveling abroad or staying home and soaking up the sunshine. Turn to our Cary, NC primary care physicians and pediatricians for travel shots, sunburn care, bee sting treatments and more!

So get outside and play this summer -- without the worry of summer healthcare concerns. At Generations Family Practice, our Cary, NC doctors are committed to convenient, thoughtful and patient-centered care. No matter what this summer brings you, you can count on Generations Family Practice for help you stay healthy!

Do You Know Your Car Seat Safety Requirements?

Tuesday, 17 July, 2018

The recommendations keep changing, but the goals are always the same...keeping our children safe. 

Did you know…Car safety seats reduce the risk of fatal injuries by 71% for infants and by 54% for children ages 1-4year? BUT these statistics are only accurate for properly installed car safety seats. 

Did you also know…70% of children are not properly restrained?

The nut and bolts…

  • Infants to 2 years old are best protected in a rear facing car seat in the back, middle seat or until they reach the car seat’s height/weight requirements.
  • 2 years old and older are safest in a 5-point forward harness until they reach the maximum height/weight allowed by the car seat.
  • Seat belt positioning boosters are used when your child outgrows the forward facing 5-point harness. 
  • Children may use the seat belt if they meet the following requirements…
  1. The child’s knees bend at the edge of the seat when their back is against the back of the seat. 
  2. The lap belt fits over the lap/thighs-not the abdomen. 
  3. The shoulder strap rests along the collar bone and shoulder-not the neck. 
  4. In general a child meets these criteria when they are 57in, between 80-100lbs, and between 8-10years.
  • Front seat? Back is always best…the latest recommendation is to wait until your child is 13 years old to be in the front seat.

References for more detailed information and free inspection locations:  (includes link to a free car seat check app)


(Written by Christine Macomber, MD, staff pediatrician at Generations Family Practice)

Preventive Care Visits at Generations Family Practice

Tuesday, 17 July, 2018

In this day and age of higher health insurance premiums with reduced benefits, it's important for patients to be informed consumers. With the onslaught of the HSA came higher costs to patients and an inkling of the real cost of healthcare.

It's important for patients to understand the difference between preventive care (i.e. a physical) and a regular office visit. Many HSA plans will cover a patient's preventive care in full, while regular office visits are subject to deductible.  What does this mean for the patient? You are entitled to a comprehensive medical exam and screening blood work. Unfortunately, given the higher costs to patients we oftentimes find patients schedule their physicals, but come in with a list of maladies. Time allotted for a yearly exam does not allow for the addition of sinus infections, abdominal pain, severe headaches, et cetera.

When issues arise during the course of the physical exam, or if the patient raises specific complaints in addition to the physical, this can result in an additional office visit charge.

In reviewing your lab results your provider may notice abnormal values, which may require further treatment or office visits. These cannot be viewed as an extension of your physical.

I liken this to six month check-ups at the dentist. While preventive care may be covered at 100%, any cavities or treatments required would fall outside the realm of preventive medicine.

I feel the pain of the costs of healthcare myself and empathize with many people less fortunate than myself. If you have any questions about the costs or the difference between a physical and an office visit, please do not hesitate to call and ask. We are here to help, but we are not able to retroactively change a visit type after the fact, so please ask beforehand if you are not sure.

Jennifer Sethi, Office Manager

Be of good cheer! Ways to beat those holiday blues

Tuesday, 17 July, 2018

With all the fall and winter holidays one after the other, the sight of all the changing decorations remind us that time is passing quickly. For many of us, the season of comfort and joy truly is that. But for many others, feeling sad during this time period is common. For many people, this time that others see as cheerful reminds us of sad events or losses from our childhoods, with our parents or grandparents, or the fantasy family we never had. And for everyone, during the last two months of the year, we all experience heightened stress due to money issues, lost love ones and unrealistic expectations magnified by the media surge.

To put some “comfort and joy” into your fall and winter, consider these tips:

Spend just the right amount of time with people you love. Many of us come from complicated families. Though we love them, visits with some of them can be stressful. If this is true for you, limit the amount of time for visits. All-day celebrations can be cut down to two hours. Or, you can visit those relatives at other times during the year when you feel less pressured by the season. Send those people cards, with the suggestion to get together another time.

Set financial goals. Your love for your family cannot be measured in dollars. If you cannot spend a lot on gifts due to your budget, don’t feel guilty. Spending more than you plan will make you feel guilty and stressed later. So instead, you may want to consider just sending a card with a nice note to some relatives. If you do give gifts, be sure to set a realistic budget and stick to it. Also, many families pick the names of just one relative, so each person only buys one gift. For a real twist on giving, get everybody on board to do a white elephant gift exchange. Or shop in consignment shops for beautiful presents that might even be new. Recycle gifts that you receive if they are sitting on your shelf, make cookies or a cake, or buy smaller specialty items like real maple syrup, which is always appreciated on holiday mornings, and always a treat.

Make a schedule so you do not feel rushed. Life today is lived in speed-up mode, and we feel pressed for time. This includes almost everyone: working people, mothers with little children, and people who are primary caregivers for the elderly. This is amplified during the month of November and December due to family obligations, holiday shopping and forced social engagements. To deal with the rush, setting specific times for shopping and visiting others is essential. Block out a period of time to shop and also to visit friends and family. Last minute shopping increases your stress levels. In addition, try to limit yourself to one social obligation every other day so these events will not feel overwhelming. This will also help children and older relatives  cope with the coming and going around family events. Schedule in the most important festivities that will help you see most of your loved ones at one time. Let go of those non-essential events that have more to do with strangers.

Set realistic expectations. Don't set yourself up for failure. Take time out for yourself by arranging to see those people who make you feel loved and supported. How you spend your time during the holiday season needs to reflect your own life and its constraints. You decide what is most important to you and focus on it. Life is not a dress rehearsal - it's the real thing.

Take a look at the following websites for more helpful suggestions:
University of Maryland School of Medicine:
Psychology Today magazine: